neglect
Acute tonsillitis, which includes tonsillopharyngitis, is a common condition, particularly in childhood. It is mostly caused by a viral infection. Symptomatic treatment is of high importance. But which treatment is effective and which isn’t?
For this expert consensus, 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprised 5 survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.
Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). The panel felt that AM was an adequate therapy for acute tonsillitis.
The authors of this paper concluded that the clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.
I found it hard to decide whether to cry or to laugh while reading this paper.
Experience in anthroposophic paediatric medicine does not make anyone an expert in anything other than BS.
Expert consensus and clinical guidelines are not conducted by assembling a few people who all are in favour of a certain therapy while ignoring the scientific evidence.
AM for acute tonsillitis in children is nonsense, whatever these pseudo-experts claim.
Imagine we run a Delphi process with a few long-standing members of ‘the flat earth society’ and ask them to tell us about the shape of the earth …
…I rest my case.
The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:
There are three types of health professionals who offer naturopathic treatment:
- Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
- Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
- Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.
At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.
Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.
… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…
ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”
… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.
…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.
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The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:
- How reliable are the claims made by naturopathic influencers?
- Naturopath jailed for selling fraudulent vaccination documents
- Naturopath fined for misdiagnosing and treating a rectal tumor for hemorrhoids
- Naturopaths are ‘not bound by science,’ lawyer argues
- Vaccination rates of Canadian healthcare professionals: those of chiropractors and naturopaths are at the lowest
- Is veterinary naturopathy animal abuse?
- Naturopathic ‘cancer specialist’ using coffee enemas found guilty
- Patients consulting chiropractors, homeopaths, or naturopaths are less likely to agree to the flu jab
- A naturopath responsible for the death of two cancer patients was sentenced to two years
- A naturopath in court after two of his cancer patients died
- Many naturopaths, homeopaths, and chiropractors are a risk to public health
- Naturopath treats autism with fecal transplants
- A naturopath promoting fake news about COVID vaccinations
- Naturopathy (according to the WNF) = quackery steeped in obsolete fantasies
- Canadian naturopaths may no longer call themselves ‘medically trained’
- Naturopaths’ counselling against vaccinations could be criminally negligent
- Naturopathy for cancer … claims that have the potential to be lethal
- Severe liver injury due to naturopaths’ prescription of Epsom salt
- Naturopaths should not treat children
- Some naturopaths are clearly a danger to public health
- Death of a child through naturopathy
Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.
An article entitled “Homeopathy for worm infestations in children’s” caught my eye. Here is the un altered abstract:
Unusual sorts of worms can be there in a child’s stomach and may initiate several health complications such as pain, infection etc. To treat worm infections, one must identify about various categories of worms, and after understanding the kind of infection induced by the worm’s the treatment for the babies or children can planned. There are various Homeopathic medicines available which be used to treat worm infections without any side effects on the health of the children’s. In this paper we have discussed how the worm infection has been treated at our homeopathic research institute.
In the paper itself, the author, Dr. AK Dwivedi (Professor and H.O.D, Department of Physiology and Biochemistry, SKRP Guajarati Medical College, Indore, Madhya Pradesh, India), explains:
Homeopathic do not take care of just the disease, but is prescribed on the base of physical, emotional and genetic condition of a person. Homeopathic medicines act on both the mental and physical levels of individuals. Homeopathy is a natural and mild system of medicines that utilizes minute doses of well-researched remedies to improve the body’s natural curing procedure. Homeopathic medicines originate from substances that come’s from plants, minerals & animals.
The author’s conclusion is equally impressive:
On the basis of our research and after analysing the patients after medication we have found that homeopathy can completely cure the worm infection, If the dosages are properly prescribed and taken on that basis of investigation reports from time to time under guidance of experienced Homeopathic Physician worm infection can be treated with homeopathy effectively.
Yes, this level of incompetence could be quite funny! But sadly, it is also quite concerning. Most worm infestations are easily treated with effective conventional therapies. Untreated, they can have serious consequences. To advocate homeopathy – which is of course ineffective – is irresponsible, unethical and arguably criminal, in my view.
Millions of US adults use so-called alternative medicine (SCAM). In 2012, 55 million adults spent $28.3 billion on SCAMs, comparable to 9% of total out-of-pocket health care expenditures. A recent analysis conducted by the US National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH) suggests a substantial increase in the overall use of SCAM by American adults from 2002 to 2022. The paper published in the Journal of the American Medical Association, highlights a surge in the use of SCAM particularly for pain management.
Data from the 2002, 2012, and 2022 National Health Interview Surveys (NHISs) were employed to evaluate changes in the use of 7 SCAMs:
- yoga,
- meditation,
- massage therapy,
- chiropractic,
- acupuncture,
- naturopathy,
- guided imagery/progressive muscle relaxation.
The key findings include:
- The percentage of individuals who reported using at least one of the SCAMs increased from 19.2% in 2002 to 36.7% in 2022.
- The use of yoga, meditation, and massage therapy experienced the most significant growth.
- Use of yoga increased from 5% in 2002 to 16% in 2022.
- Meditation became the most popular SCAM in 2022, with an increase from 7.5% in 2002 to 17.3% in 2022.
- Acupuncture saw an increase from 1% in 2002 to 2.2% in 2022.
- The smallest rise was noted for chiropractic, from 79 to 86%
The analyses also suggested a rise in the proportion of US adults using SCAMs specifically for pain management. Among participants using any SCAM, the percentage reporting use for pain management increased from 42% in 2002 to 49% in 2022.
Limitations of the survey include:
- decreasing NHIS response rates over time,
- possible recall bias,
- cross-sectional data,
- differences in the wording of the surveys.
The NCCIH researchers like such surveys and tend to put a positive spin on them, i.e. SCAM is becoming more and more popular because it is supported by better and better evidence. Therefore, SCAM should be available to everyone who wants is.
But, of course, the spin could also turn in the opposite direction, i.e. the risk/benefit balance for most SCAMs is either negative or uncertain, and their cost-benefit remains unclear – as seen regularly on this blog. Therefore, the fact that SCAM seems to be getting more popular is of increasing concern. In particular, more consideration ought to be given to the indirect risks of SCAM (think, for instance, only of the influence SCAM practitioners have on the vaccination rates) that we often discuss here but that the NCCIH conveniently tends to ignore.
This review aimed to investigate and categorize the causes and consequences of ‘quack medicine’ in the healthcare.
A scoping review, using the 5 stages of Arksey and O’Malley’s framework, was conducted to retrieve and analyze the literature. International databases including the PubMed, Scopus, Embase and Web of Science and also national Iranian databases were searched to find peer reviewed published literature in English and Persian languages. Grey literature was also included. Meta-Synthesis was applied to analyze the findings through an inductive approach.
Out of 3794 initially identified studies, 30 were selected for this review. Based on the findings of this research, the causes of quackery in the health were divided into six categories:
- political,
- economic,
- socio-cultural,
- technical-organizational,
- legal,
- and psychological.
Additionally, the consequences of this issue were classified into three categories:
- health,
- economic,
- and social.
Economic and social factors were found to have the most significant impact on the prevalence of quackery in the health sector. Legal and technical-organizational factors played a crucial role in facilitating fraudulent practices, resulting in severe health consequences.
The authors concluded that it is evident that governing bodies and health systems must prioritize addressing economic and social factors in combating quackery in the health sector. Special attention should be paid to the issue of cultural development and community education to strengthen the mechanisms that lead to the society access to standard affordable services. Efforts should be made also to improve the efficiency of legislation, implementation and evaluation systems to effectively tackle this issue.
The authors point out that, in the health systems, particularly those of developing countries, a phenomenon known as “Quack Medicine” has been a persistent problem, causing harm in various branches of health care services. They define quackery as unproven or fraudulent medical practices that have no scientifically plausible rationale behind them. Someone who does not have professional qualification, formal registration from a legitimated institution, or required knowledge of a particular branch of medicine but practices in the field of medicine, is a quack, according to the authors’ definition. Finally, they define quack medicine as a fraudulent practice of quacks claiming to possess the ability and experience to diagnose and treat diseases, and pretending that the medicine or treatment they provide are effective, generally for personal and financial gain.
The authors rightly point out that, in some countries, there may be a lack of willpower, determination and effort among political leaders to deal with and prevent fraud and charlatanism in various fields, especially in the health system. This can be due to conflict of interests, corruption network, or insufficient infrastructure and resources, such as financial capacity and human resources. In some cases, they stress, policy makers may choose to tolerate small levels of unproven medical practices if the cost of prosecuting and correcting the situation outweigh the financial benefits. This can lead to a cycle of continued fraud and a lack of effective interventions to address the issue. In many countries laws against quack medicine do exist. However, their effectiveness depends on proper and strict implementation. More efforts and measures must be taken to implement the existing laws. Inadequate enforcement of laws and approval of pseudo-medicine can result in people receiving improper care.
The authors recommend that the healthcare systems, prioritize addressing economic and sociocultural factors in order to effectively combat this issue. In developing solutions, attention must be given to cultural development and community education, and efforts should be made to strengthen mechanisms that provide access to affordable, standard healthcare services for all. Lastly, it is crucial to enhance the performance of systems responsible for legislation, implementation and evaluation of laws and regulations related to quack medicine.
It has been reported that the New York State Department of Health has issued a $300,000 penalty as part of a Stipulation and Order signed by a Nassau County midwife who created false immunization records. Roughly 1,500 school-aged children from throughout the State are affected by the vaccine scheme, which has resulted in their immunization records being voided. All affected children must be fully up to date with all age-appropriate immunizations, or be in the process of receiving their missing vaccinations, before they can return to school.
“Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health,” State Health Commissioner Dr. James McDonald said. “Let it be clear, the New York State Department of Health takes this issue seriously and will investigate and use all enforcement tools at its disposal against those who have been found to have committed such violations.” State Education Commissioner Betty A. Rosa said: “By intentionally falsifying immunization records for students, this licensed health care professional not only endangered the health and safety of our school communities but also undermined public trust. We are pleased to have worked with our partners in government to bring this wrongdoer to justice. We remain committed to upholding the highest standards of health and well-being within our educational institutions.”
The vaccination scheme began at the start of the 2019-2020 school year, just three months after the June 2019 elimination of non-medical exemptions for required school immunizations. Breen supplied patients with the “Real Immunity Homeoprophylaxis Program,” a series of oral pellets marketed by an out-of-state homeopath as an alternative to vaccination. The homeopathic pellets are not authorized by the U.S. Food and Drug Administration (FDA) nor approved by the Centers for Disease Control and Prevention (CDC) or the Department as an immunizing agent against any disease.
Breen was found to have administered 12,449 fake ‘homeopathic’ immunizations to roughly 1,500 school-aged patients as pretext for submitting false information to the New York State Immunization Information System (NYSIIS). The agreed-upon settlement reached between the Department and Breen is the first of its kind addressing a scheme to create false immunization records. It includes a $300,000 monetary penalty and requires that Breen never again administer a vaccination that must be reported to NYSIIS. In addition, Breen is permanently excluded from accessing NYSIIS under any circumstances.
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We have discussed the absurd and dangerous idea of homeoparophylaxis several times before, e.g.:
- Recommending homeoprophylaxis is unethical, irresponsible and possibly even criminal
- Second Annual Homeoprophylaxis (Natural Immunity) Conference: a sumit of irresponsibility
- Let’s be blunt: homeopathy is bogus – but homeoprophylaxis is worse, much worse!
- Understanding homeoprophylaxis: it is dangerous nonsense!!!
- “Homeoprophylaxis, the homeopathic vaccine alternative, prevents disease through nosodes.”
Suffice to stress just this:
Homeoprophylaxis is a criminally stupid way to endanger lives!
Proponents of so-called alternative medicine (SCAM) are often – as we had many opportunities to observe here on this blog – not impressed with the safety and efficacy of COVID vaccinations. This is despite the fact that several studies have demonstrated the huge number of lives saved by them, both at national and multi-country level in the earlier stages of the pandemic. I wonder whether the doubters will be convinced by new evidence.
This analysis estimates how many lives were directly saved by vaccinating adults against COVID in the Region, from December 2020 through March 2023.
The researchers estimated the number of lives directly saved by age-group, vaccine dose and circulating Variant of Concern (VOC) period, both regionally and nationally, using weekly data on COVID-19 mortality and COVID-19 vaccine uptake reported by 34 European areas and territories (CAT), and vaccine effectiveness (VE) data from the literature. They calculated the percentage reduction in the number of expected and reported deaths.
The authors found that vaccines reduced deaths by 57% overall (CAT range: 15% to 75%), representing ∼1.4 million lives saved in those aged ≥25 years (range: 0.7 million to 2.6 million): 96% of lives saved were aged ≥60 years and 52% were aged ≥80 years; first boosters saved 51%, and 67% were saved during the Omicron period.
The authors concluded that over nearly 2.5 years, most lives saved by COVID-19 vaccination were in older adults by first booster dose and during the Omicron period, reinforcing the importance of up-to-date vaccination among these most at-risk individuals. Further modelling work should evaluate indirect effects of vaccination and public health and social measures.
The authors feel that their results reinforce the importance of up-to-date COVID-19 vaccination, particularly among older age-groups. Communication campaigns supporting COVID-19 vaccination should stress the value of COVID-19 vaccination in saving lives to ensure vulnerable groups are up-to-date with vaccination ahead of periods of potential increased transmission.
Those SCAM proponents who are not convinced of the merits of COVID and other vaccinations will undoubtedly claim that this new analysis was biased and thus unreliable. Therefore, it seems worth stating that this work was supported by a US Centers for Disease Control cooperative agreement, who had no role in data analysis or interpretation. The authors affiliated with the World Health Organization (WHO) are alone responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the WHO.
Representatives of six Australian professional organizations of so-called alternative medicine (SCAM) developed a survey for e-mail distribution to members. The anonymous online Qualtrics survey was based on previous surveys to identify workforce trends over time. Survey data were analyzed descriptively using Qualtrics and STATA statistical software.
Responses were recorded from 1921 participants. Respondents were predominantly female (79.7%); 71.8% were aged over 45 years. Remedial massage therapists represented 32.1% and naturopaths represented 23.7% of respondents. Highest qualifications were diplomas (37.7%), bachelor’s degrees (28.9%), and advanced diplomas (21.8%). Metropolitan locations accounted for 68.1% of practices. Solo private practice was the main practice setting (59.8%); 13.8% practiced in group private practice with SCAM practitioners; and 10.6% practiced with allied health practitioners. Approximately three quarters of respondents (73.9%) saw 0–5 new clients per week; 42.2% had 0–5 follow-up consultations per week. Collaboration rates with SCAM practitioners, other non-SCAM practitioners, and general medical practitioners (GPs) were 68.7%, 24.4%, and 9.2%, respectively. A total of 93% did not suspect an adverse event from their treatment in the past year. Businesses of 75.9% of respondents were reportedly affected by the pandemic.
The authors concluded that comparisons with previous surveys show ongoing predominance of female practitioners, an aging workforce, a high proportion of remedial massage and naturopathy practitioners, and an increasingly qualified SCAM workforce. There was little change in the very low number of adverse events suspected by practitioners, number of consultations per week, and low levels of income of most SCAM practitioners compared with the average income in Australia. Respondents collaborated at similar rates as in the past; however, more with SCAM practitioners than with GPs.
Yet another fairly useless SCAM survey to add to the endless list of similarly wasteful investigations!
If I had to extract anything potentially relevant from it, it would be just three points:
- The authors speak of an ‘increasingly qualified workforce’. The basis for this claim is that the highest qualifications were diplomas (37.7%), bachelor’s degrees (28.9%), and advanced diplomas (21.8%). Oh dear, oh dear! Anyone can issue ‘diplomas’ which are not recognised qualifications. In other words, the SCAM workforce is woefully underqualified to take charge of patients.
- Only 9% of SCAM practitioners ‘collaborated’ with GPs. By collaboration, the authors mean the very minimum of informing the GPs what type of SCAM they might be getting. Such information can be essential for avoiding harm (e.g. interactions with prescribed drugs). In other words, even the minimum of ethical and safe practice is not met in 91% of the cases.
- The fact that a total of 93% SCAM practitioners did not suspect a single adverse event from their treatment in the past year is extraordinary. It does, I fear, not demonstrate thaat SCAM id safe but that SCAM practitioners are totally oblivious to the possibility of adverse effects. In other words, they don’t inquire about adverse effects and thus don’t notice any.
Yes, these are data from Australia, and one could argue that elsewhere the situation is different. But different does not necessarily mean better. Until I see convincing evidence, I am not optimistic about the clinical practice of SCAM. Altogether, these findings do not convince me that SCAM practitioners should be let anywhere near a person who needs medical attention.
On this blog, I have often been highly critical of integrative (or integrated) medicine (IM) – see, for instance:
- Integrative medicine: a satirical perspective
- A slightly different perspective on ‘INTEGRATIVE MEDICINE’
- Memorandum ‘INTEGRATIVE MEDICINE’
- Prince Charles’ opening speech at the ‘biggest ever’, ‘history-making’ integrative medicine conference
- The European Parliament’s Pathetic Attempt to Dabble in Integrative Medicine
- Integrative Medicine or Infiltrative Pseudoscience?
- Integrative Medicine: here is my slightly altered and much improved version
- More uncomfortable thoughts on ‘integrative medicine’
- The reality of ‘integrative medicine’ consists of little more than re-discoveries from conventional medicine, platitudes and outright nonsense
Recently, I began to realize that my previously critical stance has been largely due to the fact that 1) a plethora of definitions of IM exist causing endless confusion, 2) most, if not all, of the definitions of IM are vague and insufficient. At the same time, IM is making more and more inroads which makes it imprudent to ignore it.
I therefore decided it is time to change my view on IM and think more constructively. The first step on this new journey is to define IM in such a way that all interested parties can come on board. So, please allow me to present to you a definition of IM that is constructive and in the interest of progress:
IM is defined as the form of healthcare that employs the best available research to clinical care integrating evidence on all types of interventions with clinical expertise and patient values. By best available research, I mean clinically relevant (i.e., patient oriented) research that:
- establishes the efficacy and safety of all types of therapeutic, rehabilitative, or preventive healthcare strategies and
- seeks to understand the patient experience.
Healthcare practitioners who are dedicated to IM use their clinical skills and prior experience to identify each patient’s unique clinical situation, applying the evidence tailored to the individual’s risks versus benefits of potential interventions. Ultimately, the goal of IM is to support the patient by contextualising the evidence with their preferences, concerns, and expectations. This results in a process of shared decision making, in which the patient’s values, circumstances, and setting dictate the best care.
If applied appropriately, IM has the potential to be a great equaliser – striving for equitable care for patients in disparate parts of the world. Furthermore, IM can play a role in policy making; politicians are increasingly speaking to their use of research evidence to inform their decision making as a declaration of legitimacy. IM reflects the work of countless people who have improved the process of generating clinical evidence over several decades, and that it continues to evolve.
Developing the skills to practise IM requires access to evidence, opportunities to practise, and time. IM proponents strive to find novel ways to integrate evidence into personal holistic health in the best interest of our patients.
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I feel confident that this could create a basis for a fresh start in the dabate about the merits of IM. I for one am all for it!
In case some of my readers thought that the wording of my definition sounded somewhat familiar, I should perhaps tell you that it is my adaptation of the definition of evidence-based medicine (EBM) as published in ‘BMJ Best Practice‘.
What does that mean?
The points I am trying to make are the ones that I have tried to get across many times before:
- IM is a flawed, unethical, superflous and counter-productive concept.
- It is flawed because it is aimed at smuggling unproven or disproven treatments into routine care which can only render healthcare less safe and less effective.
- It is unethical because it cannot provide the best possible healthcare and thus is not in the best interest of patients.
- It is superflous because the aspects of IM that might seem valuable to proponents of so-called alternative medicine (SCAM) are already part of EBM.
- It is counter-productive because it distracts from the laudable efforts of EBM.
In total, 404 respondents completed the survey, of which 254 (62.9%) treated cancer patients. Most practitioners were acupuncturists and herbalists (57.1%), had (16.8 ± 9.9) years of clinical experience and see a median of 2 (1, 4) cancer patients per week. Breast cancer (61.8%) is the most common cancer type seen in SCAM clinics. Adjunctive SCAM treatments are frequently concurrent with the patient’s cancer specific treatment (39.9%), which is also reflected by the main goal of a SCAM treatment to alleviate side effects (52.4%). However, only 28.0% of the respondents are in contact with the treating oncologist. According to the respondents, pain is most effectively treated using acupuncture, while herbal medicine is best for cancer-related fatigue. SCAM practitioners mostly use certified courses (33.1%) or online databases (28.3%) but often believe that experts are more reliable to inform their practice (37.0%) than research publications (32.7%).
The authors concluded that acupuncturists and herbalists commonly treat cancer patients. Most practitioners use SCAM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines.
You would think that the combined expertise of these institutions are capable of producing a decent survey:
- Palliative Care Unit, Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
- Northern College of Acupuncture, York YO1 6LJ, United Kingdom
- School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, United Kingdom
- National Institute of Complementary Medicine Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
- Translational Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
- Medical Research Institute of New Zealand, Wellington 6021, New Zealand
- Translational Oncology, University Hospital of Augsburg, 86156 Augsburg, Germany
Well, you would have been mistaken! This surely is one of the worst investigations I have seen for a while. Here are just three reasons why:
- The researchers designed an anonymous self-completion questionnaire collecting data about the participating practitioners’ demographics and clinical practice of integrative oncology. Someone should tell them that one ought to validate questionnairs before using them and that validated questionnairs exist. Unvalidated questionnairs cannot tell us much of value.
- The researchers invited SCAM practitioners in Austria, Germany, USA, Australia, and New Zealand to participate in this study. Invitations were distributed through social media and emails between October 2022 and December 2022 by professional organizations. Someone should tell them that research needs to be reproducible and surveys need to cover a representative population – both criteria that are not met here.
- The survey participants had to hold a valid license to perform acupuncture, herbal medicine, or both. That excludes all other SCAM practitioners.
Despite these serious flaws, the survey shows two findings that might be worth mentioning:
- only 28.0% of the SCAM practitioners were in contact with the treating oncologist;
- SCAM practitioners believe that “experts” are more reliable to inform their practice than research publications.
For me, these two points alone would be sufficient reason to run a mile!
